a patient is experiencing a manic episode which nursing intervention is most appropriate
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Nursing Elites

ATI RN

ATI Mental Health Practice A

1. During a manic episode, which nursing intervention is most appropriate?

Correct answer: B

Rationale: During a manic episode, individuals may experience heightened energy levels and reduced impulse control. Providing a structured environment with limited stimuli is the most appropriate nursing intervention. This approach helps reduce excessive stimulation and potential triggers for further escalation of manic behavior. It promotes a calming and controlled setting, assisting in managing symptoms and promoting the patient's well-being. Encouraging group activities (Choice A) may lead to overstimulation, allowing the patient to engage in physical activities freely (Choice C) could be risky due to impulsivity, and giving detailed tasks (Choice D) might overwhelm the individual.

2. A client with schizophrenia is experiencing delusions. Which intervention should the nurse implement to address this symptom?

Correct answer: B

Rationale: When a client with schizophrenia is experiencing delusions, providing reality-based feedback is considered an effective intervention to address this symptom. This approach helps the client differentiate between what is real and what is not real, assisting them in managing their delusions and promoting their overall well-being. Choice A is incorrect because ignoring the delusions does not help the client in distinguishing reality from delusions. Choice C is incorrect as distraction may only provide temporary relief but does not address the underlying issue. Choice D is incorrect because encouraging the client to discuss the delusions may reinforce or intensify them rather than help in managing them effectively.

3. Which of the following statements should a healthcare professional recognize as true about defense mechanisms? Select the one that doesn't apply.

Correct answer: B

Rationale: Defense mechanisms are employed by the ego in the face of threats to biological and psychological integrity to relieve mild to moderate anxiety. They act as protective devices for the ego, not the id or superego. The id represents primal instincts, while the superego is associated with moral standards. Defense mechanisms help individuals cope with stressors by redirecting focus and are often unconscious and self-deceptive.

4. Which statement about the concept of psychoses is most accurate?

Correct answer: B

Rationale: The most accurate statement about psychoses is that individuals experiencing it often exhibit limited distress because they are not fully aware of their altered perception of reality. They may not recognize that their behaviors are maladaptive or acknowledge the presence of psychological issues. Choice A is incorrect because individuals with psychoses may not be aware that their behaviors are maladaptive. Choice C is incorrect because individuals with psychoses may not have insight into their psychological problems. Choice D is incorrect because individuals with psychoses often struggle to differentiate between reality and their altered perceptions.

5. Devastated by a divorce from an abusive husband, a wife completes grief counseling. Which statement by the wife should indicate to a nurse that the client is in the acceptance stage of grief?

Correct answer: C

Rationale: The nurse should recognize that the client is in the acceptance stage of grief based on the statement 'Yes, it was a difficult relationship, but I think I have learned from the experience.' In this statement, the client is acknowledging the difficulty of the relationship but also expressing personal growth and learning from the experience, indicating acceptance. Choices A, B, and D do not reflect the acceptance stage of grief. Choice A shows a sense of regret and a wish for things to have turned out differently. Choice B demonstrates lingering anger towards the ex-husband. Choice D suggests ongoing physical manifestations of grief like loss of appetite and weight loss, which are more indicative of earlier stages of grief.

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